Antiemetic Drugs Flashcards
what are the TYPES OF NAUSEA & VOMITING
- CHEMOTHERAPY INDUCED
- POSTOPERATIVE
- GENERAL
what are our types of ANTIEMETIC/ANTINAUSEA DRUGS? (7)
- ANTICHOLINERGIC DRUGS
- ANTIHISTAMINES (H1 RECEPTOR BLOCKERS)
- ANTIDOPAMINERGIC DRUGS
- NERUOKININ ANTAGONISTS
- PROKINETIC DRUGS
- SEROTONIN BLOCKERS
- TETRAHYDRO CANNABINOIDS
MOA of ANTIEMETICS / ANTINAUSEA DRUGS
- often work by BLOCKING the VOMITING PATHWAYS; by BLOCKING the STIMULUS
- varies depending on class
- overall PREVENTS & REDUCES N & V
anticholinergic drugs (ACh blockers)
- work by BLOCKING ACh RECEPTORS within the INNER EAR LABYRINTH
- blocks NAUSEA STIMULI to the CTZ [CHEMORECEPTOR REACTOR ZONE]
- able to BLOCK TRANSMISSION of that stimuli from reaching the RETICULAR FORMATION seen in the VC [VENTRAL CAPSULE]
ex. SCOPOLAMINE (SCOPACE)
- type of 72 TRANSDERMAL PATCH - 1 mg
antihistamine drugs (H1 RECEPTOR BLOCKERS)
- inhibits ACh from binding to H1 RECEPTORS
- able to PREVENT CHOLINERGIC STIMULATION within the VESTIB. and RETICULAR AREAS
- often used for MOTION SICKNESS, NONPRODUCTIVE COUGH, ALLERGIES or SEDATION
ex.
Dimenhydrinate (Dramamine)
Diphenhydramine (Benadryl)
Meclizine (Antivert)
Hydroxyzine (Vistaril)—PO or IM
only, never IV
antidopaminergic drugs
- blocks the DOPAMINE RECEPTORS in the CTZ
- used for PSYCH DISORDERS/INTRACTABLE HICCUPS
examples:
Prochlorperazine (Compazine)
Promethazine (Phenergan)
- PO/IM preferred / IV
- XX never through INTRAARTERIAL ROUTE
DROPERIDOL
- can have CARDIAC DISRHYMIAS
AMISULPRIDE (BARHEMSYS) - newest
neurokinin receptor antagonists
- INHIBITS the SUBSTANCE P/NEUROKININ 1 RECEPTORS within the BRAINSTEM
- often used with SEROTONIN BLOCKERS & GLUCOCORTICOIDS
[helps to delay chemotherapy-induced emesis]
examples;
- APREPITANT
- FOSAPREPITANT
- ROLAPITANT
prokinetic drugs
- blocks the DOPAMINE RECEPTORS in the CTZ»_space; becomes desensitized to any impulses from the GI TRACT (important for stimulating PERISTALSIS)
- used for GERD/DELAYED GASTRIC EMPTYING
ex. METOCLOPRAMIDE (REGLAN)
**long term use - IRREVERSIBLE TARDIVE DYSKINESIA
serotonin blockers
- blocks SEROTONIN RECEPTORS in the GI/CTZ/VC
- used for N/V in CHEMO and for POSTOP
examples;
Dolasetron (Anzemet)
Granisetron (Kytril)
Ondansetron (Zofran)
Palonosetron (Aloxi)
**all end in TRON
tetra-hydro cannabinoids
- is a MAJOR PSYCHOACTIVE SUBSTANCE in MARIJUANA
- causes INHIBITORY EFFECTS on the RETICULAR FORMATION, THALAMUS, and CEREBRAL CORTEX
- can alter MOOD and PERCEPTION; can help relieve N&V
- often used for N&V - CHEMO / ANOREXIA - weight loss in AIDS
ex. DRONABINOL (MARINOL)
ginger
- used for N&V - CHEMO/MORNING SICKNESS/MOTION SICKNESS
adv effects;
- ANOREXIA
- N&V
- SKIN RXNs
DRUG INTERACTIONS;
- increases ABSORPTION of oral meds
- increases BLEEDING risk with anticoagulants
nursing implications
- assess history of N&V/ any precipitating factors?
- current meds?
- caution with drowsiness/ driving/ any hazardous tasls/ slow position changes
- taking with ALCOHOL; can cause CNS DEPRESSION
chemotherapy implications
- ANTIEMETICS given around 30-60 min before starting
